The Corpus Christi Heart Project (CCHP) was originally funded in 1987 and renewed in 1992 to implement a surveillance program for hospitalized cases of coronary heart disease (CHD) occurring among women and men in the biethnic population of Mexican-Americans (MA) and non-Hispanic whites (NHW) ages 25-74 residing in Corpus Christi (Nueces County), Texas. The central hypotheses posed in this coronary surveillance study concerned differences in the natural history of CHD in these four sex-ethnic groups, including the role of diabetes. Case identification was made on the basis of complete ascertainment within defined categories of hospitalized cases of CHD occurring among community residents. However, the study of out-of-hospital deaths due to coronary disease was not carried out as part of the activities of this surveillance program. Limited data are available concerning the magnitude of and differences in out-of-hospital deaths due to CHD according to ethnicity and sex, particularly from a community-wide perspective. Therefore, to have a more complete and accurate picture of the community burden from CHD, out-of-hospital deaths, as well as those occurring in-hospital, should be investigated. The investigators have begun the study of out-of- hospital deaths due to CHD with funds obtained from the CDC over the past 2 years. In the present application, funds are requested to continue to identify, collect data, and validate cause of death for potential CHD deaths that occur in out-of-hospital settings for residents of Corpus Christi, Texas. By the end of this research project, the investigators state that they should be able to contribute useful information to the understanding of both out-of-hospital CHD mortality and total community CHD mortality among MA and NHW women and men. The specific aims of the proposed out-of-hospital CHD death surveillance study are as follow: 1) to calculate validated out-of-hospital death rates for CHD in this biethnic community in order to test the hypothesis that age-adjusted, out-of-hospital CHD death rates are lower among MA than among NHW for both men and women; 2) to determine whether diabetes displaces CHD as the reported underlying cause of death more frequently among MA than among NHW and to determine whether or not MA and NHW decedents with diabetes have CHD, stroke, and renal failure diagnoses recorded among the multiple causes of death similarly; and 3) to determine the total community mortality rates from acute myocardial infarction (AMI) and chronic CHD to test the hypothesis that MA will have higher total community AMI and chronic CHD mortality rates than NHW for both women and men by combining data from the proposed project and the ongoing hospital-based surveillance project.